Colchicine is a very old drug and is made from the Autumn Crocus, Colchicum autumnale (a poisonous European flowering plant). It has been primarily used in the treatment of gout. Although it is not formally indicated or approved for the treatment of dermatological diseases, colchicine has been prescribed for some skin conditions with good results. Its effectiveness is due to several immunological and anti-inflammatory properties.
In New Zealand colchicine is available as 0.5mg tablets (previously 0.6mg).
Because of its potential toxicity, colchicine is used as a secondline agent when safer drugs have been unsuccessful.
Colchicine for dermatological diseases
Colchicine is used for a number of dermatological diseases. Its effectiveness has only been shown through the treatment of small and mostly uncontrolled study groups.
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More controlled and double-blind studies are needed to prove the usefulness of colchicine in dermatological diseases.
Contraindications to colchicine
Colchicine should not be used under the following circumstances:
- Patients with a known hypersensitivity (allergy) to the medicine
- Patients with serious gastrointestinal, kidney, liver or heart disorders
- Patients with blood diseases in which there are low numbers of white cells or platelets
Precautions when using colchicine
Colchicine can be fatal in overdose. Treatment with colchicine should be stopped immediately when abdominal pain, diarrhoea, nausea or vomiting occur. These are the first signs of toxicity and usually occur between 0–24 hours after taking the medicine.
Side effects of colchicine
The most common side effects are abdominal pain, diarrhoea, nausea or vomiting, which occur in up to 80% of patients receiving a maximal dose. Gastrointestinal symptoms are worse at higher dosages. These symptoms indicate toxicity and the medicine should be stopped.
Toxicity results in:
- Bone marrow depression resulting in agranulocytosis (absent white blood cells) and thrombocytopenia (low numbers of platelets)
- Peripheral neuritis (nerve inflammation affecting hands and feet)
- Purpura (bleeding into the skin)
- Myopathy (weak muscles)
- Loss of hair
- Azoospermia (absent sperm production).
- Cardiac arrhythmia (palpitations) and low blood pressure
- Lung, kidney and liver failure
Colchicine, when used in low doses, has a low rate of side effects. Beneficial effects without the side effects is possible by reducing the dosage. However, there is no antidote if an excessive dose is taken. Seek medical help immediately.
- Book: Textbook of Dermatology. Ed Rook A, Wilkinson DS, Ebling FJB, Champion RH, Burton JL. Fourth edition. Blackwell Scientific Publications.
- Sullivan TP, King LE, Boyd AS. Colchicine in dermatology. Journal of the American Academy of Dermatology 1998;39: 993-9. Medline.
- Keeping patients informed about colchicine use. Prescriber Update 2014;35(4):49
On DermNet NZ:
- Medicaction Alert 8 Colchicine June 2009 – Safe and Quality Use of Medicines, DHBNZ New Zealand
- Consumer medicine information and data sheets – Medsafe
- Drugs, Herbs and Supplements – MedlinePlus
- Colchicine: Lower doses for greater safety: Medsafe
- Colchicine – British Association of Dermatologists
Books about skin diseases:
See the DermNet NZ bookstore
The New Zealand approved datasheet is the official source of information for this prescription medicine, including approved uses and risk information. Check the New Zealand datasheet on the Medsafe website.